More stories

  • in

    Gilead Agrees to Allow Generic Version of Groundbreaking H.I.V. Shot in Poor Countries

    Many middle-income countries are left out of the deal, widening a gulf in access to critical medicines.The drugmaker Gilead Sciences on Wednesday announced a plan to allow six generic pharmaceutical companies in Asia and North Africa to make and sell at a lower price its groundbreaking drug lenacapavir, a twice-yearly injection that provides near-total protection from infection with H.I.V.Those companies will be permitted to sell the drug in 120 countries, including all the countries with the highest rates of H.I.V., which are in sub-Saharan Africa. Gilead will not charge the generic drugmakers for the licenses.Gilead says the deal, made just weeks after clinical trial results showed how well the drug works, will provide rapid and broad access to a medication that has the potential to end the decades-long H.I.V. pandemic.But the deal leaves out most middle- and high-income countries — including Brazil, Colombia, Mexico, China and Russia — that together account for about 20 percent of new H.I.V. infections. Gilead will sell its version of the drug in those countries at higher prices. The omission reflects a widening gulf in health care access that is increasingly isolating the people in the middle.Gilead charges $42,250 per patient per year for lenacapavir in the United States, where it is approved as a treatment for H.I.V. The company has said nothing about what lenacapavir will cost when used to prevent H.I.V. infections, a process called pre-exposure prophylaxis, or PrEP.The generics makers — four companies in India, one in Pakistan and one in Egypt — are expected to sell it for much less. Researchers at Liverpool University found the drug could profitably be produced for as little as $40 per patient per year, if it were being purchased in large volumes.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

  • in

    Francisco Lopera, the ‘Country Doctor’ Who Upended Our Understanding of Dementia

    Francisco Lopera defied rebels, cartels and vampire bats to become a pioneering researcher of Alzheimer’s disease.In 1978, Dr. Francisco Lopera did what recent medical school graduates in Colombia and much of Latin America have long done: He set out for an obligatory year of work in a remote part of the country, where an inexperienced médico rural might be the only physician for miles. Dr. Lopera, who was born in the Andean region of Antioquia and knew mostly mountains and farm life before medical school, carried out his service in the Darién Gap, on the Caribbean coast near Panama.There Dr. Lopera, a groundbreaking Colombian Alzheimer’s researcher who died this week at age 73, treated stabbings, snakebites, complicated births, burns and fevers in a hospital that had electricity for only half the day. On one occasion, he was kidnapped by Marxist guerrillas. Another time, he had to flee gunshots.When I met Dr. Lopera in 2017, to start research on a book about the families with Alzheimer’s that became his life’s work, he told me a story about two young brothers who had died one after the other in his hospital, of unknown causes. Lopera traveled to the family home in a remote jungle clearing, where he discovered that the boys’ surviving siblings had bites on their fingers from vampire bats. He sent the bodies to a pathology lab hours away by boat, and the pathologists confirmed rabies. When the government brought in a rabies expert to investigate, Dr. Lopera joined him.He left that experience — long nights in the rainforest, searching for hidden roosts, engrossed in the natural history of rabies and bats — wanting to become a rabies epidemiologist. But that was not to be. His interests were eclectic and quick to change, and a few years later he became a neurology resident in Medellín.In 1984, Dr. Lopera examined a farmer in his 40s who appeared to have dementia. Dr. Lopera took again the unusual step of traveling to the family home, in a mountain hamlet like the one where he had been born. Not just the farmer had symptoms of dementia, he saw — a brother also appeared to be affected. Dr. Lopera had discovered what would turn out to be the world’s largest family with early-onset Alzheimer’s disease. The family shared a genetic mutation, later nicknamed the paisa mutation, that was unique to their region of Colombia. Dr. Lopera spent the next four decades studying the family’s 6,000 members.Dr. Francisco Lopera, second from right, in Yarumal, Colombia, in 2010, with Oderis Villegas, center, who was showing signs of Alzheimer’s disease at age 50. A sister, María Elsy, left, had a more advanced case.Todd Heisler/The New York TimesWe are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

  • in

    Ex-Green Beret Goudreau, Who Planned Failed Venezuela Coup, Is Arrested

    Jordan Goudreau, 48, had taken credit for a failed coup attempt against Nicolás Maduro of Venezuela. He faces federal charges of illegal arms smuggling.A former U.S. Green Beret who orchestrated a disastrous failed coup attempt against the authoritarian president Nicolás Maduro of Venezuela in 2020 was arrested Tuesday in New York on federal arms smuggling charges.The federal authorities accused Jordan G. Goudreau, 48, and a co-conspirator, Yacsy Alexandra Alvarez, of exporting military-style rifles, night vision devices, lasers, silencers and other military equipment without a license to Colombia beginning in November 2019 for use in carrying out “activities in Venezuela,” the Justice Department said in a news release on Wednesday.The charges appear to refer to the botched cross-border raid carried out in May 2020 by dozens of armed, self-declared freedom fighters, including former Venezuelan soldiers and former American Special Forces operators, who aimed to topple Mr. Maduro.Mr. Goudreau, of Melbourne, Fla., who did not participate in the raid, publicly took credit for the failed incursion known as Operation Gideon, which he said he had planned with disaffected Venezuelan officials. The audacious rebellion left observers around the world wondering why a decorated former U.S. Special Forces soldier who had served several tours in Iraq and Afghanistan was leading a foreign insurrection.A group of only about 60 men had planned to land on Venezuelan soil near the capital, Caracas, from speedboats and ultimately capture Mr. Maduro. But they were repelled by the Venezuelan security forces. Six men were killed and 13 others were detained, including two former Green Berets who were said to have been recruited by Mr. Goudreau, according to The Associated Press. The Americans were sentenced to 20 years in prison by the Venezuelan authorities in August 2020 but were released in a prisoner exchange deal with the United States late last year.Mr. Goudreau and Ms. Alvarez, a Venezuelan national who lives in Tampa, Fla., face charges of conspiracy to violate export laws, smuggling goods from the United States and violating federal firearm export control acts, prosecutors said.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

  • in

    Las elecciones en Venezuela le dan un espaldarazo a los autócratas

    Nicolás Maduro, el líder autoritario de Venezuela, parece haber sobrevivido una vez más en unas elecciones que lucen profundamente injustas y plagadas de irregularidades. El resultado, que ya enfrenta resistencia y ha ocasionado disturbios que podrían aumentar en los próximos días, no es solo una decepción para la oposición y los millones de venezolanos que anhelan un cambio democrático. Las elecciones también han sido una prueba crucial de la permanencia del nuevo tipo de autoritarismo que se apodera del continente americano, y han demostrado que esa tendencia no desaparecerá pronto.La democracia está siendo sofocada o seriamente desafiada en todo el hemisferio occidental. En los últimos 20 años, Venezuela, Nicaragua y El Salvador han derivado en dictaduras. Aunque acabó detenido, el entonces presidente de Perú intentó disolver el Congreso a finales de 2022. El año pasado, Guatemala estuvo a punto de seguir esta tendencia cuando el Ministerio Público buscó impedir una transición pacífica del poder. Y queda por ver si la recién elegida próxima presidenta de México, Claudia Sheinbaum, continuará la erosión de los controles y equilibrios democráticos que inició su predecesor.El panorama no es tan desalentador. En otros lugares —Brasil, Chile, Colombia y Estados Unidos— la democracia está triunfando. Pero se está poniendo a prueba a medida que crece la oposición al pluralismo y la inclusión y se extiende el malestar social y la insatisfacción con el gobierno en un contexto de clara desigualdad e inestabilidad institucional.Las elecciones de Venezuela son un momento decisivo para América. A pesar de la alta participación, se registraron numerosos reportes de irregularidades en los comicios, intimidación de votantes y problemas en los centros de votación. Sin embargo, con el 80 por ciento de los votos escrutados, el Consejo Nacional Electoral declaró ganador a Maduro con el 51,2 por ciento de los votos, frente al 44,2 por ciento de su principal contrincante. Debido a que los funcionarios de muchos centros de votación se negaron a entregar copias físicas de los recuentos de votos, la oposición no tenía modo concreto de señalar un resultado distinto.Si Maduro logra sortear la agitación poselectoral y mantenerse en el poder otro mandato, dará pie a que otros autócratas en ciernes de la región sepan que también pueden actuar con casi total impunidad. Los procesos electorales cuestionables, los abusos contra los derechos humanos y la corrupción podrían extenderse si no se coordina una respuesta internacional contra ellos, mientras que las voces de los electores de esos países son apagadas por la represión. El retroceso de la democracia es algo que ya ha ocurrido: muchas democracias incipientes de Latinoamérica se perdieron durante la Guerra Fría y regresaron después de que terminara.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

  • in

    Se está postulando al Senado con una historia de migrante humilde. Te contamos el resto

    Bernie Moreno, el republicano que se enfrenta al senador Sherrod Brown en Ohio, cuenta una historia de rico venido a menos que volvió a ser rico. Pero la realidad no es tan clara.Se está postulando para el Senado de EE. UU. como un migrante exitoso. Está contactando a los votantes de Ohio con una historia conmovedora, de alguien que superó los obstáculos por sus propios medios, y que solo pudo haberlo hecho en un lugar como Estados Unidos al llegar siendo un niño desde Colombia, arriesgarse con un negocio que estaba en dificultades y luego al convertirlo en un éxito rotundo, volviéndose multimillonario en el proceso.Bajo la bandera del movimiento político populista de Donald Trump, Bernie Moreno, el republicano que está retando al senador Sherrod Brown, se autodenomina humildemente un “tipo que vende automóviles en Cleveland” y relata las modestas circunstancias de su infancia, cuando su familia migrante empezó de cero en Estados Unidos.“Llegamos aquí sin absolutamente nada —llegamos aquí de manera legal– pero llegamos aquí, nueve de nosotros en un apartamento de dos habitaciones”, contó Moreno en 2023, en lo que se convirtió en su discurso característico. Su padre “tuvo que dejarlo todo atrás”, ha dicho, recordando lo que llamó el “estatus de clase media baja” de su familia.Pero hay muchas más cosas que Moreno no dice sobre sus antecedentes, su educación y sus poderosos vínculos actuales con el país que lo vio nacer. Moreno nació en una familia rica y con conexiones políticas en Bogotá, una ciudad que nunca abandonó del todo y donde algunos de sus familiares continúan disfrutando de gran riqueza y estatus.Brown en Dayton, Ohio, en marzoMaddie McGarvey para The New York TimesWe are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

  • in

    Bernie Moreno says he fled socialism in Colombia for the US in 1971. What does history say?

    Bernie Moreno, the Republican candidate for US Senate in Ohio who expected to mount a stern challenge to Sherrod Brown, the incumbent leftwing Democrat, says his family fled socialism when they came to the US from Colombia in 1971, when he was four years old.Though such statements formed a central part of Moreno’s campaign message on his way to securing the Republican nomination with support from Donald Trump, they do not withstand historical scrutiny.In an interview in 2020, about his success as a car dealer in Ohio, Moreno described himself as “somebody who moved to this country a long time ago to escape what happens in most South American countries, which is socialism and the absolute prison of those ideas”.In 2021, as Moreno moved into national politics with a first run for a Senate nomination, the Cleveland Plain Dealer said he “says he came to the United States as a child with his mother and siblings to flee socialism in their native Colombia. He believes that same ideology is rising in the United States, and he wants to fight back.”But when Moreno was born, on 14 February 1967, Colombia was nine years into the 16-year period of National Front government, in which conservative and liberal parties alternated being in power as a way to avoid violence between the two factions.Furthermore, the first leftwing Colombian government in modern times is the current one, headed by Gustavo Petro and in power since 2022.Colombia has long been home to leftwing guerrilla groups. As described by the US Congressional Research Service, when Moreno lived there, the country was home to “leftist, Marxist-inspired insurgencies … including the Farc, launched in 1964, and the smaller National Liberation Army (ELN), which formed the following year”.Such groups, the CRS says, “conducted kidnappings, committed serious human rights violations, and carried out a campaign of terror that aimed to unseat the central government in Bogotá”.Moreno, however, has described an early childhood far removed from such worries.By his own description, his father was secretary of health under Misael Pastrana, a conservative and the last National Front president between 1970 and 1974.“We had a very, very, very, very incredible lifestyle in Colombia,” Moreno said in 2019, at a business event in Cleveland, adding that his mother moved the family to the US – initially against his father’s wishes – because she “didn’t want us to be raised as pampered indoor cats”.The move was “a jump”, Moreno said, “but it was this idea of no fear”.Contacted for comment on Wednesday, Moreno’s communications director, Reagan McCarthy, said: “No where in the [first] quote cited does Bernie say his family came to America because Colombia was a socialist country or that his family was escaping a socialist country at the time.“He very clearly was stating that many South American countries fell to socialism and his parents came to America to ensure their kids would grow up in a free society, out of fear that Colombia would eventually move towards socialism.”As indicated by McCarthy’s reference to “many South American countries [falling] to socialism”, Moreno has also spoken of a fear of being “surrounded” by socialist governments.In 2021, writing in the Toledo Blade, he said: “I was born in South America, surrounded by socialist ideology.”The same year, Moreno told the Landscape, a Cleveland podcast: “I think the [US is] going off [in] a very dangerous direction. It’s a direction I recognise. I grew up surrounded by socialist ideology, whether it’s Venezuela or Cuba [or] now Peru, and I know where this movie ends.”And in a campaign ad, also from 2021, Moreno said: “I came from a country surrounded by the ideology of radicals like Fidel Castro and Che Guevara, who promised to give everyone all they needed and solve all their problems, just like [Vermont senator] Bernie Sanders and AOC [New York congresswoman Alexandria Ocasio-Cortez] are doing today.”Such claims also shake under scrutiny.Cuba has indeed been governed from the left since 1959, when Castro and the Communist party took power after a long fight. Castro was assisted by Guevara, a revolutionary from Argentina – who was killed in October 1967, when Moreno was eight months old.In the late 1960s and early 1970s, when Moreno was a young child in Colombia, Venezuela was governed by Rafael Caldera, a Christian Democrat who moved to end conflict with leftwing guerrillas. Ecuador, which also borders Colombia, was also governed by a centrist at that time.Between 1968 and 1975, Peru was led by Juan Velasco Alvarado, a general who seized power in a coup d’état but governed from the political centre. The current president of Peru, Dina Boluarte, is a former member of a Marxist party now governing with the support of rightwingers.Between 1970 and 1973, Chile – more than a thousand miles south of Colombia – was governed by Salvador Allende, its first socialist president. He died on 11 September 1973 as the rightwing Chilean military led by Gen Augusto Pinochet attacked the presidential palace, in a coup backed by the CIA.After coming to the US in 1971, Moreno became a US citizen at 18. In her statement on Wednesday, McCarthy, the Moreno aide, accused the Guardian of failing to celebrate “what could potentially be the first South American-born senator”.The National Republican Senatorial Committee and Democratic Senatorial Campaign Committee did not respond to requests for comment. A spokesperson for Brown declined to comment. More

  • in

    Migration Through Darien

    On Friday, boat companies began operating in Colombia after a five-day pause, allowing migrants to once again make their way through the notorious jungle terrain and continue toward the U.S. border.Migration toward the United States through the perilous jungle known as the Darién Gap returned to normal on Friday, with hundreds of people from Venezuela, Ecuador and beyond entering the jungle following a roughly five-day pause in which migrants could not begin the trek.The pause in this increasingly large migration flow was the result of an arrest operation led by the Colombian prosecutor’s office, in which two captains driving boats full of migrants headed to the jungle were taken into custody, where they remain, according to the prosecutor’s office. The office said that the captains had been transporting the individuals illegally, in part because the migrants did not carry proper documentation.The captains worked for two boat companies — Katamaranes and Caribe — that for years have been playing an essential role in carrying migrants from the northern Colombia community of Necoclí about two hours across a gulf to the entrance to the jungle, which they must then cross to get to Central America and eventually the United States. The boat companies have been doing this openly — something documented extensively by The New York Times — and the arrests seemed to signal a shift in policy by Colombian authorities.But in retaliation for the arrests, the boat companies paused transport, and the number of migrants waiting around in Necoclí and another exit town, Turbo, swelled quickly to several thousand people. That posed an enormous challenge to both towns, which do not have the resources or infrastructure to house and feed so many people for an extended amount of time.The arrests of the boat operators came after months of pressure by the United States on the Colombian government to do more to limit or stop migration through the Darién. In a recent interview, Hugo Tovar, a Colombian prosecutor, said his office was working diligently, with the help of the United States, to investigate and arrest human traffickers.On Friday, Johann Wachter, secretary of the Necoclí municipal government, said that the boat companies decided to restart operations after a meeting between representatives from the boat companies, local governments, the Colombian national migration office and other agencies, including someone from the U.S. Embassy in Colombia.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

  • in

    Colombia, Normally a Wet Country, Battles Widespread Wildfires

    Firefighters, many of them volunteers, have been confronting dozens of blazes amid high temperatures this month. The conditions have been linked to climate change.Helicopters hauling buckets of water fly toward the mountains where fires burn, a thick haze periodically covers the sky, and residents have been ordered to wear masks and limit driving because of the poor air quality.For a full week, firefighters have been battling fires in the mountains around Bogotá, Colombia’s capital, as dozens of other blazes have burned across the country, in what officials say is the hottest January in three decades.The president has declared a national disaster and asked for international help fighting the fires, which he says could reach beyond the Andes Mountains and erupt on the Pacific Coast and in the Amazon.Colombia’s fires this month are unusual in a country where people are more accustomed to torrential rain and mudslides than fire and ash. They have been attributed to high temperatures and drought exacerbated by the climate phenomenon known as El Niño.Ricardo Lozano, a geologist and former environment minister of Colombia, said El Niño was a natural phenomenon that occurred cyclically, but that with climate change, “these events are more and more intense and more and more extreme.”Heavy smoke from wildfires near the capital, Bogotá.Federico Rios for The New York TimesWe are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber?  More